Sr Manager, Waste & Error Operations

CVS Health•Hartford, CT

4d•$82,940 - $182,549

About The Position

The Sr Manager, Waste & Error Operations is responsible for leading strategic, operational, and technology-driven initiatives that support Payment Integrity programs. This role oversees a multi-functional team and collaborates across business, operational, and technical organizations to drive program performance, automation, cost avoidance, and operational excellence. The position serves as operational support for Itemized Bill Review (IBR), Facility Charge Review (FCR), and Non-par Negotiations programs. The role combines people leadership, strategic planning, program management, business process improvement, and technology implementation to deliver scalable solutions and measurable business results.

Requirements

7+ years of work experience
2+ years of direct leadership/management experience supervising teams or equivalent Medical Claim Management experience
2+ years of experience with ACAS program and processes
2+ years of experience within the healthcare industry
1+ years of experience leading cross functional projects
Intermediate level experience with Microsoft products; Excel and Word
Strong analytical, problem-solving, and decision-making skills.
Excellent verbal and written communication skills with the ability to present to leadership audiences.
Experience managing multiple priorities and driving results in a fast-paced environment.

Nice To Haves

Experience with Payment Integrity or Claims Operations
Experience with QuickBase and SharePoint including creation and maintenance of
Knowledge of healthcare claims auditing, reimbursement methodologies and provider payment processes.

Responsibilities

Lead and develop a high-performing team, including U.S.-based and offshore resources, to achieve operational and business objectives.
Oversee end-to-end operations for Itemized Bill Review (IBR), Facility Charge Review (FCR), and Non-Participating Provider (Non-Par) Negotiations.
Serve as an escalation point for complex members, provider, client, network, and compliance issues.
Manage daily operations, workflow, inventory, and performance to ensure quality, productivity, and service-level objectives are met.
Recruit, develop, coach, and retain talent through effective onboarding, training, performance management, and career development.
Lead team meetings, conduct regular one-on-one meetings, communications, and training to reinforce priorities, expectations, and employee engagement.
Drive process improvements and operational efficiencies through workflow optimization, automation, AI, and RPA initiatives.
Support Payment Integrity and other strategic initiatives through planning, implementation, and operational execution.
Lead operational projects from concept through deployment, ensuring sustainable outcomes and business value.
Analyze performance data and develop recommendations that improve efficiency, reduce costs, and deliver measurable ROI.
Prepare and present operational insights, reports, and recommendations to support leadership decision-making.
Partner with Operations, IT, Analytics, Legal, Compliance, Network, and other stakeholders to successfully execute programs and initiatives.
Support change management efforts by driving stakeholder engagement, process adoption, and operational readiness.
Contribute to budget planning, resource prioritization, and investment decisions supporting business growth and transformation.
Foster a culture of accountability, collaboration, continuous improvement, and regulatory compliance.